Funder: California Health Care Foundation

September 2020 | Profile


Between 2016 and 2020, Washington State transitioned from separate Medicaid systems for managing physical health, mental health, and substance use disorder care to a single system of integrated managed care organizations for physical and behavioral health needs. In designing this new system, the state sought to advance more integrated, coordinated care for individuals with co-occurring physical and behavioral health conditions living in the state. Implementation of this model, known as fully integrated managed care, was phased in with regional adaptations that created new roles for public regional behavioral health systems. Initial evaluations demonstrate promising outcomes.

This case study describing Washington State’s journey to integrated care offers lessons for designing and implementing state efforts to advance physical-behavioral health integration, as well as in tailoring regional approaches to use the expertise of local behavioral health stakeholders.